(PS9-92) Revisiting Childhood Memories: Benefit of Fulfilling Unmet Needs in Imagery Rescripting

Abstract Text: Background and

Objectives: Imagery rescripting (ImR) is an affective change strategy core to schema therapy. Within this treatment, an influential negative memory tied to an early maladaptive schema (e.g., mistrust) is modified so that unmet childhood needs are fulfilled (e.g., security and protection from caregivers). Meta-analyses indicate that ImR is an efficacious intervention for many psychiatric disorders. Although ImR significantly reduces symptoms of psychopathology, the agent of change within this technique is unclear. The current study evaluates whether the therapeutic effects of ImR are achieved by revisiting the childhood event as an adult or by fulfilling one’s unmet needs (i.e., the rescripting process).

Methods: Participants (N = 246) were undergraduate students from three separate institutions who reported a significantly negative and influential childhood memory in which an authority figure induced guilt. Following random assignment, participants were administered an automated intervention - full ImR (revisited the childhood memory in first person and present tense, identified their unmet needs, and imagined their adult-self meeting the needs of their child-self) or the Control condition (i.e., only revisited the memory in first person and present tense). Following the 15-minute therapeutic exercise, participants in both conditions provided pre-post ratings on previously demonstrated cognitive (e.g., meaning-making) and affective (e.g., emotion regulation) ImR targets.

Results: Mixed effects models, with a random intercept of subject nested within site, tested study hypotheses and Q-Q and density plots of the residuals ensured model appropriateness. Aligning with study predictions, participants in the ImR condition reported comparatively greater mastery, self-compassion, and emotion regulation, as well as a significant reduction in distress, helplessness, and belief strength regarding the way the world works. Notably, participants receiving ImR reported a 20% improvement in emotion regulation abilities after a 15-minute automated intervention.

Discussion: Study results indicate that a core element of ImR – fulfilling unmet childhood needs – leads to immediate adaptive changes in cognitive and affective targets, over and above that of revisiting the aversive memory through “child eyes.” Given the large sample, attempts to control for confounds (therapist effects; activation of an idiosyncratic aversive memory in the Control group), and use of psychometrically valid measures, results possess strong internal and ecological validity. Moreover, participants’ engagement with, and success at, rescripting a memory involving guilt – an emotion linked to many forms of psychopathology – reflects the potentially wide-ranging utility of this automated ImR. This also parallels past research on the benefits of writing interventions for historical traumas in at-risk and clinical populations. Although the stability of the ImR effects were not evaluated, future researchers should explore the long-term impact of this automated intervention on memory features, as well as associated symptoms of psychopathology.